Alex Azar and Eli Lilly have opposed policies that would make healthcare more affordable for Americans. Photo: Michael Reynolds/EPA

As I wrote a few weeks back on these blog pages, President Trump’s nomination of Alex Azar to lead the Department of Health and Human Services will help Big Pharma continue to get away with murder; something the president says he opposes. Mr. Azar just left Eli Lilly USA earlier this year as its president. Under his tenure with Lilly, Azar vehemently opposed importing lower-cost medications from Canada among other polices to tackle high drug prices.

In my capacity as founder of Prescription Justice, I published an op-ed in The Guardian called “Alex Azar is big pharma personified. He must not become US health secretary.” A Big Pharma executive is not the right pick to get this country moving on lowering drug prices. I’m just saying…

Yesterday, President Trump declared the opioid crisis a public health emergency, which hopefully will jumpstart the nation’s response to get more treatment to addicts, including medications that can save them from overdose, and empower law enforcement to more successfully pursue and stop illegal (and even legal) distribution of opioids that have killed hundreds of thousands. This is NOT the time to ease up on the administration or Congress regarding the public health crisis of high drug prices or to let Big Pharma use it as a pretext to curtail access to more affordable, imported (non-opioid) medication. Just last week we wrote about Trump saying for a second time that drug companies were getting away with murder because of drug prices. He should have added for drug dealing as well.

As I wrote in The Hill back in June, Big Pharma is not only responsible for high drug prices but also for causing opioid abuse and death in America. They want to use a crackdown on illegal opioid imports to stop safe drug importation, which is a lifeline for millions of Americans who cannot afford the outrageous prices the drug industry controls here at home.

The drug companies’ front groups are supporting legislation called the Synthetics Trafficking Opioid Prevent Act (STOP). STOP’s goal is to cease illegal imports of fentanyl, a drug sold lawfully in the U.S., which is often used as an ingredient to make opioid-based street drugs and even counterfeit versions of prescription narcotics. Well, I support that idea, too! Who wouldn’t? Here’s the problem with the bill: That same legislation could also impede Americans who import real, non-opioid, non-controlled medication for their own use because they can’t afford it here!

Pharma’s death machine has no boundaries. Op-eds continue to infest the Internet and daily newspapers warning that legalizing imports of lower-cost medication from Canada will worsen the opioid crisis. Most that I’ve read are written by paid lobbyists, consultants, or employees of drug companies.

Is Mary Bono a lobbyist for Pharma? According to Open Secrets, ASOP has spent $420,000 this year lobbying on importation and online pharmacies alone. I believe that Ms. Bono genuinely wants to stop dangerous illegal sales of prescription narcotics and even regular drugs – but to mix it all in with a narrative that perpetuates that ALL international online pharmacies are dangerous is wrong. You’ll notice on the Open Secrets page that the executive director of ASOP, Libby Baney, is a principal at Faegre Baker Daniels and a lobbyist.

Safe international online pharmacies help Americans afford medication to treat high blood pressure, diabetes, asthma, depression, heart disease and many other conditions. They require valid prescriptions, meet high standards of pharmacy practice, and have nothing to do with the opioid crisis. PharmacyChecker explicitly bans any websitefrom our Verification Program that sells prescription opioids to patients in the U.S., or any controlled medication, as defined by the U.S. Drug Enforcement Agency.

The tragedy of hundreds of thousands of deaths by opioid abuse and overdose in America is nothing short of disgraceful. It’s well-known that the pharmaceutical industry’s commercial greed bears much responsibility. One example is that the pharmaceutical industry pushed for looser prescribing rules to expand opioid sales to people who don’t really need them. More recently, investigative reporting showed that Pharma lobbied for the successful passage of legislation to prevent the DEA from going after companies violating opioid drug distribution laws. This has led to unnecessary deaths, and yet we continue to let Big Pharma sweep the truth under the rug.

The FDA has never reported a death due to ordering medication from an international online pharmacy that required valid prescription. Never. Juxtapose that with the 200,000 who have died from opioids. Also, the FDA notes that 125,000 Americans have died because they have not taken prescribed medication. Why haven’t they? Often because they can’t afford it. Based on Commonwealth Fund surveys, we’ve estimated about 45 million didn’t fill a prescription because of cost in 2016.

I’ve been saying for years now that the pharmaceutical industry is misleading the public and Congress on prescription drug importation in a major way. So, I’ll say it again: the opioid crisis should not be a pretext to make it harder for Americans to afford non-opioid drugs internationally.

Yes, but it depends where you live. For example, if you live in Florida, according to Kaiser Health News, apparently it’s very easy to find a local “storefront” where you can buy lower cost medication from Canada and other countries. Of course, consumers do not need to go to a pharmacy storefront to benefit from lower drug prices in other countries. They can compare drug prices among safe international online pharmacies in our Verification Program.

As with most personal drug importation, the FDA has said importing meds from foreign pharmacies is technically illegal under most circumstances. In practice, the FDA does not prosecute individuals for importing small quantities of prescription drugs for personal use. According to Kaiser Health News, the pharmacy storefronts in Florida have not faced regulatory actions. A professor of health policy at University of South Florida, Sean Greggory, stated that shutting down storefronts “would be seen as restricting access to affordable drugs and supporting big bad [drug] corporations.”

PharmacyChecker.com checks the credentials of international online pharmacies to verify that they are licensed and operating properly but to date we have not checked storefront pharmacy operations. However, over the years, we’ve heard about storefronts throughout the U.S. that refer orders to pharmacies in other countries and, if those pharmacies are licensed and operating safety, we think it’s great!

The need for the storefronts is greatest among older Americans. Their Part D Medicare drug plans are not always adequate to cover prescription costs and seniors continue to face drug affordability problems. The storefronts, like international online pharmacies, offer much lower prices on brand name drugs than local U.S. pharmacies.

When online pharmacies, particularly the Canadian options, were first available over 15 years ago, many seniors did not know how to use the Internet or felt uncomfortable doing so. In 2000, only 14% of seniors used the Internet, compared to 58% in 2015 [Source]. But that still leaves a lot of seniors who might have trouble ordering medication online by themselves. For them, pharmacy storefronts can be a lifeline. As the Kaiser article points out, while “Many consumers do their own online buying from foreign pharmacies…storefront operators target an older generation interested in buying medicines abroad but who lack computer savvy and are insecure about buying online by themselves.”